Naloxone: A Life-Saving Medication We Should All Have on Hand

The statistics are staggering. Opioid-involved deaths in the U.S. rose from more than 49,000 in 2019 to more than 81,000 in 2022, according to the National Institute on Drug Abuse. Those most at risk are between the ages of 35-44; this group has seen an 83% increase in deadly opioid overdose since 2019, says the National Safety Council.

Among teenagers between 14-18, the numbers are just as bad: About 90% of fatal drug overdoses involved opioids, and 84% involved illegally manufactured fentanyl, according to the Centers for Disease Control (CDC).

But there is a powerful way to combat these numbers. A medication called naloxone has become more widely accessible as a life-saving tool to help manage the deadly opioid crisis. Although this drug has been available in intravenous and intramuscular forms for decades, naloxone was FDA-approved as a nasal spray in 2015. It became available without a prescription in 2023, making it easier for the public to use.

Adam Blumenberg, MD, an assistant professor of emergency medicine at Columbia, sees opioid overdoses in the emergency department, trains other medical professionals about recognizing and treating an opioid overdose, and has even administered naloxone in a city park. He explained what naloxone is, how it’s given, and why we should all have it on hand.

What are opioids?

Opioids are a drug class that includes heroin, as well as pain relievers available legally by prescription, such as fentanyl, tramadol, oxycodone (OxyContin®, Percocet®), hydrocodone (Vicodin®), codeine, and morphine.

And what is naloxone?

Naloxone is a generic name for FDA-approved medications better known as Narcan® and Kloxxado®. This medication can rapidly reverse the effects of an opioid overdose. Opioids, such as heroin, or prescription painkillers like oxycodone, can depress the central nervous system and slow breathing to dangerous levels. If an opioid overdose is not treated quickly, not enough oxygen gets to the heart and brain, and the person can die or become permanently disabled.

Naloxone acts as an antidote, quickly restoring normal breathing and preventing death in emergencies. It will not harm someone who doesn’t have opioids in their system.

What are some signs of an opioid overdose?

This is a great question, and if you think someone might have an opioid overdose, check if they’re responsive to voice or touch. If they are unresponsive, call 911 and check for a pulse. If a pulse is absent, start CPR. If a pulse is present, give naloxone if you have it with you. Important signs of an opioid overdose that we should all be aware of include:

• Unresponsiveness
• Slow and shallow breathing
• Tiny eye pupils
• Limp limbs (arms and legs)
• Purple fingernails and lips

The emphasis here should be on calling 911 and giving naloxone, even if you’re unsure whether the problem is caused by an opioid.

How do you give naloxone?

Narcan is available in two primary forms: intranasal spray and injectable.

The intranasal spray is a user-friendly, needle-free device that requires no assembly and can be easily administered by anyone (no medical training needed). It is sprayed into one nostril while the person is lying on their back, and the dose can be repeated if needed.

The injectable form of Narcan® is typically administered by healthcare professionals using an intramuscular injection or an intravenous line.

Where can I find Narcan®?

It is available over the counter without a prescription at participating drugstore pharmacies, communal settings, community-based programs, and state or local health departments. The NYC Health website lists participating pharmacies and other places to find it. A two-pack costs approximately $50 and is usually covered by insurance.

Can Narcan® replace emergency medical care?

Absolutely not. While Narcan® is a powerful tool in reversing opioid overdoses, it is not a substitute for emergency medical care. If Narcan® is administered, it is crucial to call 911 for emergency services immediately for expert medical attention. Additionally, it is essential to stay with the person until help arrives, as the effects of Narcan® may wear off before the opioids are entirely out of their system, and overdose symptoms may return.

Being prepared with some form of naloxone can save a life during an opioid overdose emergency. Keeping it on hand and learning how to use it could mean the difference between life and death.

Is it important to point out that naloxone for emergency overdoses is different from other treatments that address the underlying problem of addiction?

Yes, while naloxone is a wonderful life-saving medication (and it is; I have given it many times!), it can only reverse a single overdose. The U.S. has a major problem with opioid addiction, and although naloxone can save a person’s life one time and give hope, it does not solve someone’s addiction. There are other treatments and medications, such as buprenorphine and methadone, which treat the underlying disorder. Treating addiction is hard work but offers enormous positive benefits for the person, their family, and their community. Getting a person addiction treatment reduces their risk of another overdose and can not only save their life but also make their life much better.